Seniors in nursing homes have support of ombudsmen

Pam Adams

Sunday

Dec 30, 2007 at 12:01 AMDec 30, 2007 at 2:12 AM

Not only do senior cititzens have the same rights in a nursing facility as they would in their own homes, but they also have trained, paid advocates ready to press for solutions on their behalf. Three community ombudsmen, along with 18 volunteers, work out of the regional long-term care ombudsman office.

Sometimes the major complaint about a nursing home is as simple as food.

Anna wants salt, but she's on a salt-restricted diet. Arthur wants only toast for breakfast, but his caretakers insist on bringing him a full meal. Edith just doesn't like the food.

Other times, complaints are more problematic.

It takes 45 minutes before anyone responds to a call light. A roommate screams all night. A morning bath is fine, but not at 4 a.m.

And, increasingly, the complaint is an uneasy question about what to do when the nursing home serves eviction papers.

"So many residents or their families don't have a clue about their rights in a nursing facility," says Stasia Miller, regional long-term care ombudsman for the Illinois Department of Aging.

Protecting residents' rights

Not only do senior cititzens have the same rights in a nursing facility as they would in their own homes, but they also have trained, paid advocates ready to press for solutions on their behalf. Three community ombudsmen, along with 18 volunteers, work out of the regional long-term care ombudsman office.

The regional program is based out of the senior services office of the Center for Prevention of Abuse.

"We only get involved with a resident's permission," says Pat Willis, community ombudsman for nursing homes in Marshall, Woodford and part of Tazewell counties.

Shirley Patterson, community ombudsman for facilities in Fulton, Stark and most of Tazewell, worked with people who wanted to move from East Peoria Gardens Health Care Center, the nursing home in the headlines recently for a police sweep, state investigation and the questionable deaths of two residents.

J.R. Friedrich, who covers Peoria County, knew of the program before he started working as an ombudsman. He sought advice from an advocate five or six years ago in disputes with a nursing home about his father's care.

Volunteer ombudsmen are assigned to one nursing home each. Though their capacity to advocate for residents is limited, they act as "extra eyes and ears" for the community ombudsmen, Miller says.

The three community ombudsmen are seeing more of what's called "involuntary discharges," or evictions for non-payment. Ombudsmen make sure residents know their rights and, if a resident agrees, the ombudsman will help them appeal the discharge, which results in a hearing with an administrative law judge from the Illinois Department of Public Health.

The hearings may expose financial abuse or mismanagement by a relative.

Or, says Miller, officials may find that residents have run out of money but have not applied for Medicaid.

Though she estimates the office deals with about 30 to 40 involuntary discharges a month, Miller says residents are rarely evicted.

"As long as I've been doing this, nearly four years, I've only been to one hearing where a resident was asked to leave," she says. "The administrative law judge always tries to keep residents in the facility."

In any case, her office can help residents through the process.

Congress initiated the long-term care ombudsman program in the 1970s after widespread complaints about abuse and neglect at nursing homes.

The regional program covers 75 facilities - a total of 6,000 beds - licensed by the Illinois Department of Public Health in the six-county area.

The ombudsmen visit each nursing home in their territory at least once a month.

"It's a unique program," Miller says. "We do not act in the best interest of the resident; we do what they want, and that can be a challenge."

First of all, it can to difficult to gain trust and get residents to openly talk about problems. Many don't realize they can change their living conditions, and many are afraid to try.

"They're afraid of retaliation if they upset the people who care for them," Willis says.

Putting residents first

Ombudsmen advocate for what a resident wants, even if it's not what a resident needs, which can put them in conflict with family members.

"The families are not always our biggest fans," Miller says.

But advocates can try to help residents make good choices first, she says. For example, if a resident wants to go home against medical advice, an ombudsman would tell her she can, but Medicaid might not pay for a home health-care aide. Sometimes that's enough to convince someone to stay in the nursing home, Willis says.

The ombudsman's main role is to help senior citizens maintain a sense of control about their choices. "That loss of control is a huge thing for them."

Still, ombudsmen are an important source of advice and information for family members, as Friedrich's personal experience illustrates. They have lobbied state legislators for increased personal allowances for residents on Medicaid. They also remain alert to systemic problems within a nursing home and ways they can help nursing-home staff improve.

The long-term care ombudsman program conducts sensitivity training sessions designed to help nursing home staff understand what it's like to be confined to wheelchair and ignored or verbally abused. They have staff members wear glasses that simulate glaucoma or ear plugs to simulate hearing loss.

"Some staff look at us as enemies," Friedrich says. "Some look at us as people working with them to try to provide the best care possible."

But their responsibility, he reiterates, is to the residents.

Pam Adams can be reached at 686-3245 or padams@pjstar.com.

Never miss a story

Choose the plan that's right for you.
Digital access or digital and print delivery.